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World Journal of Urology

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01-07-2020 | Urinary Tract Infection | Original Article

High incidence of urinary tract infections after photoselective laser vaporisation of the prostate: a risk factor analysis of 665 patients

Authors: Kathrin Bausch, Jürg Motzer, Jan A. Roth, Marc Dangel, Hans-Helge Seifert, Andreas F. Widmer

Published in: World Journal of Urology | Issue 7/2020

Abstract

Purpose

Although photoselective laser vaporisation of the prostate (PVP) is a recognised alternative to transurethral resection in treating benign prostatic obstruction, there is limited data on the incidence and determinants of postoperative urinary tract infections (UTI). We assessed patients subjected to PVP, evaluating incidence and potential determinants of postoperative UTIs.

Materials and methods

Consecutive patients undergoing PVP between April 2010 and August 2018 were candidates for this retrospective cohort study. The primary outcome measure was microbiologically confirmed postoperative UTI. We fitted uni- and multi-variable Cox models to identify potential risk factors.

Results

Among the 665 included patients, 20% developed postoperative UTIs. The overall incidence rate per 100 patient-days was 0.65 (95% confidence interval [CI] 0.55–0.77). Risk factors for postoperative UTIs were end-stage renal failure (adjusted hazard ratio [aHR] = 14.10, 95% CI 2.08-64.58; p = 0.001) and presence of at least one of the following factors in the 3 months preceding PVP: (i) placement of urinary catheter, (ii) bacteriuria, (iii) UTI, or (iv) antimicrobial treatment (composite aHR = 1.99, 95% CI 1.22−3.24; p < 0.001). There was no apparent association between choice or duration of antimicrobial prophylaxis and incident UTIs.

Conclusions

Our analysis revealed a high incidence of UTIs after PVP and served to identify certain preoperative risk factors. Neither the choice of antimicrobial regimen nor its duration affected the incidence of UTIs. Prolonged antimicrobials proved to be disproportionately high, warranting further scrutiny in randomised controlled trials.

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Title: High incidence of urinary tract infections after photoselective laser vaporisation of the prostate: a risk factor analysis of 665 patients
Authors: Kathrin Bausch
Jürg Motzer
Jan A. Roth
Marc Dangel
Hans-Helge Seifert
Andreas F. Widmer
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Urinary Tract Infection
Transurethral Prostate Resection
Laser
Published in: World Journal of Urology / Issue 7/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02969-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High incidence of urinary tract infections after photoselective laser vaporisation of the prostate: a risk factor analysis of 665 patients

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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